[Anesthesia using propofol during surgery of strabismus in children. A comparison of two different protocols of

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M Dandoy1, F Poisson, E Lampl

  • 1Département d'Anesthésie-Réanimation, C.H.N.O. des Quinze-Vingt, Paris.

Cahiers D'Anesthesiologie
|October 1, 1990
PubMed

Insights

Protocol I, utilizing a higher propofol induction dose, demonstrated superior outcomes in pediatric strabismus surgery compared to Protocol II. This included improved induction quality, reduced injection pain, less bradycardia, and fewer post-operative nausea and vomiting incidents.

Area of Science:

  • Anesthesiology
  • Pediatric Surgery
  • Pharmacology

Background:

  • Propofol is a widely used anesthetic agent for induction and maintenance in pediatric surgery.
  • Optimizing anesthetic protocols is crucial for improving patient safety and recovery, especially in children undergoing elective procedures like strabismus surgery.
  • Understanding the comparative efficacy and safety of different propofol dosing regimens is essential for clinical practice.

Purpose of the Study:

  • To investigate and compare two distinct propofol-based anesthetic protocols for induction and maintenance in pediatric patients undergoing strabismus surgery.
  • To evaluate the quality of induction, maintenance, and recovery associated with each protocol.
  • To assess specific adverse events such as injection pain, bradycardia, nausea, and vomiting.

Main Methods:

  • A study involving 100 pediatric patients (4-8 years old, ASA I, NYHA I) scheduled for strabismus surgery.
  • Two protocols were compared: Protocol I (Propofol 6 mg/kg + fentanyl 2 mcg/kg + vecuronium 0.08 mg/kg for induction, followed by propofol 11 mg/kg/h for maintenance) and Protocol II (Propofol 3 mg/kg + fentanyl 3 mcg/kg for induction, followed by propofol 12 mg/kg/h for maintenance).
  • Key outcomes including induction quality, injection pain, intraoperative bradycardia, and postoperative nausea/vomiting were assessed.

Main Results:

  • Protocol I demonstrated a significantly better quality of induction compared to Protocol II.
  • Patients receiving Protocol I experienced a lower incidence of pain during propofol injection.
  • Protocol I was associated with a better quality of maintenance, characterized by infrequent bradycardia related to oculocardiac reflex, and a significantly reduced frequency of postoperative nausea and vomiting.

Conclusions:

  • Protocol I, involving a higher propofol induction dose, offers significant advantages over Protocol II for pediatric strabismus surgery.
  • The findings suggest that Protocol I leads to improved anesthetic induction, better intraoperative stability, and enhanced recovery with fewer adverse events.
  • This study supports the use of Protocol I as a potentially superior anesthetic strategy in this pediatric surgical population.

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